Rotation of the second cervical vertebra in pediatric patient

Rotatory instability is characterized by the rotation between two vertebral bodies, and it constitutes the most common cause of torticollis in children.^(-) This prevalence occurs because of specific anatomic characteristics of childhood, such as disproportion between head-neck, underdeveloped cervical musculature, laxity of the joint capsule, ligament elasticity and horizontal shape of the articular facets between atlas and axis vertebrae.^(-) This condition can occur due to inflammation/infection^(,,) or trauma,^(,,,) or because of neurogenic or idiopathic origin.⁽⁾

The diagnosis includes clinical and imaging exam.^(,) Among imaging exams of bone tissue, radiographies in anteroposterior and lateral projections are of limited use because they do not enable a precise visualization of this alteration, due to difficulties in positioning patients (head offset or source of X-rays, and overlap of structures), leading to radiographic interpretation challenges.^(,,) Computed tomography is considered the gold standard procedure.^(,,) Images of tridimensional reconstruction provides a global visualization of rotation, therefore helping to establish the diagnosis.^(,,) In addition, the magnetic resonance image can also be requested to evaluate the risk of vascular-nervous bundle compromising and injuries of the ligaments adjacent to vertebrae.^(,-)

[…]

Cite

150

Views